scholarly journals Secondary Syphilis in Patients Treated at the City Institute for Skin and Venereal Diseases in Belgrade from 2010 to 2014

2015 ◽  
Vol 7 (2) ◽  
pp. 53-60
Author(s):  
Milan Bjekić
Keyword(s):  
Skin Diseases ◽  
Clinical Manifestations ◽  
Secondary Syphilis ◽  
Hiv Positive ◽  
Venereal Diseases ◽  
Cutaneous Manifestations ◽  
Source Of Infection ◽  
Sex With Men ◽  
The City ◽  
Hiv Negative

AbstractThe aim of this study was to analyze the characteristics and clinical manifestations of secondary syphilis among patients registered at the City Institute for Skin and Venereal Diseases in Belgrade, during the period from 2010 to 2014. The study was designed as a case-note review. In the five-year period, a total of 62 patients with secondary syphilis were registered. The average patient age was 32 years. There were 45 (72.6%) HIV-negative, and 17 (27.4%) HIV-positive patients. The incidence of HIV–positive patients was significantly different from random distribution (p = 0.016). All HIV-positive patients were unmarried men. A significant percentage of HIV-positive patients were unemployed (p < 0.001), reported unknown source of infection (p = 0.002) and were all homosexuall (p = 0.026). More than 25% of all patients with syphilis had a history of chancres, and it was still present at the time of examination in 11.3% of all patients. The majority of cases (87.1%) had a rash, and lymphadenopathy was found in 20% of patients. However, syphilitic alopecia was detected only in HIV-positive cases (p = 0.004). There were no statistically significant differences between HIV-positive and HIV-negative patients in regard to other clinical manifestations, such as mucous patches and condylomata lata. Being a great imitator, secondary syphilis may manifest in a myriad of diverse morphological entities and clinical manifestations. We review a range of cutaneous manifestations of secondary syphilis and skin diseases it may mimic. Clinicians must be vigilant and consider syphilis in differential diagnosis, and maintain a high index of suspicion, especially when assessing vulnerable populations, such as men who have sex with men and HIV-infected individuals.

Symptomatic secondary syphilis: empirical antimicrobial treatment or await microbiology?

Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 598 ◽  
Author(s):  
Daniel Richardson ◽  
Colin Fitzpatrick ◽  
Fionnuala Finnerty ◽  
Debbie Williams
Keyword(s):  
Clinical Symptoms ◽  
Point Of Care ◽  
Secondary Syphilis ◽  
Antimicrobial Treatment ◽  
Hiv Positive ◽  
Point Of Care Testing ◽  
Treatment Delays ◽  
Sex With Men ◽  
Symptoms And Signs ◽  
Hiv Negative

Men who have sex with men (MSM) with symptomatic secondary syphilis present with characteristic symptoms of rash, fever and lymphadenopathy; due to delays in microbiology results and some patients failing to return for treatment, empirical treatment is sometimes offered. We reviewed all patients presenting with secondary syphilis diagnosed on the basis of clinical symptoms and signs and reviewed treatment. Of the 36 patients, 16 MSM (44%; 95% confidence interval (CI) 27.8–60.2%) were treated empirically, whereas treatment was delayed for 20 (56%; 95% CI 39.8–72.2%) waiting for microbiology results. Treatment delays were longer for HIV-negative than HIV-positive MSM (10 vs 5 days respectively; P = 0.01); the cumulative treatment delay was 143 days. Concerns over antimicrobial resistance and overuse of antimicrobials should drive the use of point-of-care testing for syphlis.

scholarly journals An Outbreak of Early Syphilis in Patients Registered at the City Institute for Skin and Venereal Diseases in Belgrade from 2010 to 2012: a Case Series of 86 Patients

2013 ◽  
Vol 5 (2) ◽  
pp. 65-71 ◽  
Author(s):  
Milan Bjekić ◽  
Sandra Šipetić
Keyword(s):  
Case Series ◽  
Hiv Positive ◽  
Oral Sex ◽  
Patient Counseling ◽  
Venereal Diseases ◽  
Early Syphilis ◽  
Sex With Men ◽  
The City ◽  
Latent Syphilis ◽  
Case Note Review

Abstract The purpose of this study was to analyze the characteristics of an outbreak of early syphilis registered at the City Institute for Skin and Venereal Diseases in Belgrade, during the period from 2010 to 2012. The study was designed as a case-note review. In a three-year-long period, a total of 86 patients with early syphilis were registered: 33 cases of primary, 31 of secondary and 22 cases of early latent syphilis. Sixty-five (76.5%) of all patients were men who have sex with men, 15 were heterosexual men and 6 were women. The majority of patients were infected in Belgrade, and in 51/86 cases oral sex was the only risk factor. There were 13 HIV-positive patients, all men who have sex with men. Thus, 20% of men who had sex with men in this study were co-infected with HIV. In conclusion, this outbreak of early syphilis in Belgrade, in which more than two thirds of all patients were men who have sex with men, of whom 20% were HIV-infected, shows the need for: 1) enhanced prevention efforts targeting this group more important than ever, with education and condom use for oral sex as an important part of patient counseling; 2) coordinated and expeditious surveillance, partner services, screening among population at-risk, as well as early diagnosis and treatment.

Clinical outcomes of syphilis in HIV-negative and HIV-positive MSM: occurrence of repeat syphilis episodes and non-treponemal serology responses

2021 ◽  
pp. sextrans-2020-054887
Author(s):  
Silvia Achia Nieuwenburg ◽  
Ricardo Jamie Sprenger ◽  
Maarten Franciscus Schim van der Loeff ◽  
Henry John Christiaan de Vries
Keyword(s):  
Hiv Infection ◽  
Controlled Trial ◽  
Clinical Manifestations ◽  
Response To Treatment ◽  
Disease Stage ◽  
Hiv Positive ◽  
Sexual Risk Behaviour ◽  
Serological Response ◽  
History Of ◽  
Hiv Negative

ObjectivesHIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored.MethodsThis retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3–6 months. We included data of participants with ≥1 syphilis diagnosis in 2014–2019. Pearson’s χ² test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses.ResultsWe included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68/90 (75.6%) vs 96/265 (36.2%); p<0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7/73 (9.6%) vs 36/126 (28.6%)) and more often diagnosed with secondary syphilis (16/73 (21.9%) vs 17/126 (13.5%)) and early latent syphilis (50/73 (68.5%) vs 73/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138/143 (96.5%) vs 66/74 (89.2%); p=0.032).ConclusionsIn repeat syphilis, HIV infection is associated with advanced syphilis stages and with higher non-treponemal titres. HIV infection affects the serological outcome after treatment, as an adequate titre response was observed earlier in HIV-negative MSM.

Food Insecurity Partially Mediates the Association Between Drug Use and Depressive Symptoms among Men who have Sex with Men in Los Angeles, California

2021 ◽  
pp. 1-26
Author(s):  
David A. Wiss ◽  
Marjan Javanbakht ◽  
Michael J. Li ◽  
Michael Prelip ◽  
Robert Bolan ◽  
...  
Keyword(s):  
Food Security ◽  
Depressive Symptoms ◽  
High Risk ◽  
Los Angeles ◽  
Drug Use ◽  
Food Insecurity ◽  
Hiv Positive ◽  
Sex With Men ◽  
The Relationship ◽  
Hiv Negative

Abstract Objective: To understand the relationship between drug use, food insecurity (FI), and mental health among men who have sex with men (MSM). Design: Cohort study (2014-2019) with at least one follow-up. Setting: Visits at 6-month intervals included self-assessment for FI and depressive symptoms. Urine testing results confirmed drug use. Factors associated with FI were assessed using multiple logistic regression with random effects for repeated measures. General structural equation modeling tested whether FI mediates the relationship between drug use and depressive symptoms. Participants: Data were from HIV-positive and high-risk HIV negative MSM in Los Angeles, CA (n=431; 1,192 visits). Results: At baseline, FI was reported by 50.8% of participants, depressive symptoms in 36.7%, and 52.7% of urine screening tests were positive for drugs (i.e., marijuana, opioids, methamphetamine, cocaine, ecstasy). A positive drug test was associated with a 96% increase in the odds of being food insecure (95% CI: 1.26-3.07). Compared to those with high food security, individuals with very low food security have a nearly 7-fold increase in the odds of reporting depressive symptoms (95% CI: 3.71-11.92). Findings showed 14.9% of the association between drug use (exposure) and depressive symptoms (outcome) can be explained by FI (mediator). Conclusion: The prevalence of FI among this cohort of HIV-positive and high-risk HIV-negative MSM was high; the association between drug use and depressive symptoms was partially mediated by FI. Findings suggest that enhancing access to food and nutrition may improve mood in the context of drug use, especially among MSM at risk for HIV-transmission.

scholarly journals Prevalence of Anal High-Risk Human Papillomavirus Infections Among HIV-Positive and HIV-Negative Men Who Have Sex With Men in Nigeria

2016 ◽  
Vol 43 (4) ◽  
pp. 243-248 ◽  
Author(s):  
Rebecca G. Nowak ◽  
Patti E. Gravitt ◽  
Xin He ◽  
Sosthenes Ketende ◽  
Wuese Dauda ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Hiv Positive ◽  
Papillomavirus Infections ◽  
Sex With Men ◽  
Hiv Negative

Betapapillomaviruses in the anal canal of HIV positive and HIV negative men who have sex with men

2014 ◽  
Vol 61 (2) ◽  
pp. 237-241 ◽  
Author(s):  
Boštjan Mlakar ◽  
Boštjan J. Kocjan ◽  
Lea Hošnjak ◽  
Kristina Fujs Komloš ◽  
Miloš Milošević ◽  
...  
Keyword(s):  
Anal Canal ◽  
Hiv Positive ◽  
Sex With Men ◽  
Hiv Negative

HIV-Related Attitudes and Intentions for High-Risk, Substance-Using Men Who Have Sex With Men: Associations and Clinical Implications for HIV-Positive and HIV-Negative MSM

2010 ◽  
Vol 24 (4) ◽  
pp. 281-293 ◽  
Author(s):  
Gordon Mansergh ◽  
David J. McKirnan ◽  
Stephen A. Flores ◽  
Sharon M. Hudson ◽  
Beryl A. Koblin ◽  
...  
Keyword(s):  
Substance Use ◽  
Risk Behavior ◽  
Self Efficacy ◽  
Safer Sex ◽  
Hiv Positive ◽  
Hiv Status ◽  
Anal Sex ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

This study compared HIV-related attitudes and intentions by respondent HIV-status in a large sample of substance-using men who have sex with men (MSM) in the United States. Attitudes and intentions included self-efficacy for safer sex; difficulty communicating with sex partners about safer sex; intent to use condoms consistently and to not use substances before sex in the next 3 months; and less concern for HIV given effective antiviral treatments. Differences were found for behavior during the most recent anal sex encounter by HIV-status, including (a) insertive and (b) receptive anal sex risk behavior, and (c) substance use before or during the encounter. Self-efficacy for safer sex was associated with less risk behavior among HIV-negative men but not among HIV-positive men, suggesting that self-efficacy for safer sex continues to be a relevant issue to address in counseling uninfected MSM. HIV-positive men who reported less concern for HIV given treatments were more likely to report receptive risk behavior, as were HIV-negative men who reported difficulty communicating about safer sex. Implications are discussed for potentially heightened client desire and therapeutic opportunity to reduce future substance use during sex for clients who report recent substance use during sex.

scholarly journals 423. Self-Reported Screening for Rectal Sexually Transmitted Infections Among Men Who Have Sex with Men

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S212-S213
Author(s):  
Timothy William. Menza ◽  
Lauren Lipira ◽  
Amisha Bhattarai ◽  
Joseph Ramirez ◽  
Roberto Orellana
Keyword(s):  
Sexually Transmitted Infections ◽  
Multivariable Analysis ◽  
Prevalence Ratio ◽  
Hiv Positive ◽  
Sexually Active ◽  
Hiv Status ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

Abstract Background Rectal gonorrhea and Chlamydia are common and predict HIV acquisition among men who have sex with men (MSM); however, screening for rectal sexually transmitted infections (STIs) is not routine. Methods In 2017, we recruited sexually-active MSM in the Portland, Oregon metropolitan area through venue-based sampling. Our outcome of interest was self-reported rectal STI screening in the prior 12 months. Stratified by HIV status, we assessed the prevalence and demographic, healthcare, clinical, and behavioral predictors of screening. Results Of 448 participants, 168 (37.5%) reported rectal STI screening. One hundred twenty-seven (35.8%) of 355 HIV-negative men, 41 (58.6%) of 70 HIV-positive men, and none of 23 men who did not know their HIV status reported screening. Among HIV-negative men, having a healthcare provider who offered HIV testing (adjusted prevalence ratio [aPR]=2.09; 95% confidence interval [CI]: 1.43, 3.04), a syphilis diagnosis (aPR=1.32; 95% CI: 1.03, 1.69), use of pre-exposure prophylaxis (aPR=1.57; 95% CI 1.21, 2.04), and condomless anal sex with casual partners in the prior 12 months (aPR=1.74; 95% CI: 1.36, 2.22) independently predicted screening for rectal STI in multivariable analysis. HIV-positive men who reported having a provider who always or often initiates conversations about sex were significantly more likely to report screening compared with men who did not have such a provider (aPR=1.48; 95% CI: 1.06, 2.06). Conclusion Rectal STI screening is not universal in a venue-based sample of sexually-active MSM. Implementing innovative, acceptable, and accessible screening practices and improving provider comfort with talking about sex are paramount to increasing rectal STI screening. Disclosures All authors: No reported disclosures.

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